慢性阻塞性肺疾病中炎症细胞、细胞因子与肺功能的关系

慢性阻塞性肺疾病(COPD)是一种由不同的炎性细胞、细胞因子和炎性介质介导的慢性气道炎症性疾病。炎症所涉及的部位包括呼吸道、肺血管及肺实质,气道炎症的持续存在、肺组织结构的破坏、气道的重塑、肺功能的下降都与炎性介质有关。本文就炎症反应与COPD肺功能关系作一综述,揭示炎症反应对COPD患者肺功能的影响。     

丹红注射液在慢性阻塞性肺疾病急性发作期治疗中的应用

目前慢性阻塞性肺疾病(COPD)的治疗目标是预防和控制症状的急性加重,改善患者的肺功能和健康状况.2007年7月～2008年8月,我们采用丹红注射液治疗108例COPD急性发作期患者,并观察其在抑制炎症反应、控制感染治疗中的价值.     

NLRP3炎症小体及其激活产物在慢性阻塞性肺疾病中的作用研究进展

慢性阻塞性肺疾病(COPD)是一种常见的以持续气流受限为特征的疾病,与气道和肺对有毒颗粒或气体的慢性炎症反应增强有关.COPD发病率、致死率高,造成了严重的经济和社会负担.然而迄今为止,没有一种治疗COPD的药物可以有效地阻止疾病的进展.目前认为,气道和肺部的慢性炎症是导致COPD发生发展的主要机制.然而促使炎症产生并大量扩散的机制尚不清楚.炎症小体最近被发现在呼吸系统疾病的炎症发生发展中发挥重要作用.种种证据表明香烟烟雾导致NLRP3炎症小体的活化,促使IL-1β和IL-18的成熟和释放增多,可能在COPD的慢性炎症中发挥重要作用,为临床上治疗COPD提供了新的思路.     

稳定期慢性阻塞性肺疾病气道炎症与系统性炎症关系的研究

目的 初步探讨稳定期慢性阻塞性肺疾病(COPD)气道炎症与系统性炎症的关系.方法 入选符合中华医学会呼吸病学分会2007年COPD指南的稳定期COPD患者35例.检测肺功能、痰定量细菌培养及痰细胞计数与分类、测定血浆纤维蛋白原、血清C反应蛋白(C-reactive protein,CRP)水平,分析气道炎症与系统性炎症...     

老年慢性阻塞性肺疾病气道炎症及其治疗前景

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种全球范围内慢性疾病,是发展中国家患病率增长最快的疾病之一,且老年人群中的发病率很高.气道慢性炎症尤其是小气道慢性炎症是其主要病理特征,然而目前对COPD气道炎症的本质尚不明确、治疗不能完全阻止病程进展,本文就老年COPD气道炎症研究及其治疗进展作简要综述.     

慢性阻塞性肺疾病患者合并抑郁障碍的研究简

目的 探讨慢性阻塞性肺疾病患者抑郁症发生情况及影响因素.方法 采用抑郁自评量表对90例COPD患者进行调查,明确COPD患者抑郁症的发生率,以及性别、年龄、病程、急性发作次数以及肺功能等对COPD患者抑郁发生的影响.结果 90例COPD患者有40例合并抑郁症,发病率占44.4%,其抑郁症的发病率与性别、年龄、病程、急性发作次数、合并症及肺功能有密切关系.结论 对慢性阻塞性肺疾病患者心理状况的调查以及早期干预对于提高COPD患者的治疗效果及生活质量具有重要意义.     

老年慢性阻塞性肺疾病患者血清瘦素水平与炎症及胰岛素抵抗的关系

慢性阻塞性肺疾病(COPD)是一种具有破坏性的肺疾病,其特征为不完全可逆的气流受限,且肺部对有害气体或者颗粒出现异常炎症反应,是进行性疾病[1].15岁以上人口COPD的发病率是3％[2].老年人由于多合并多种内科基础疾病,发生率和死亡率更高.瘦素是具有促进炎症和调控免疫的一种蛋白质,和胰岛抵抗关系密切.本文就收治的老年COPD患者进行瘦素和炎症以及胰岛素抵抗的临床分析.     

肥胖对慢性阻塞性肺疾病患者肺功能及预后的影响

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种具有气流受限为特征的慢性气道疾病,其气流受限呈不完全可逆、且进行性发展.多项临床研究表明COPD患者体质量改变与其肺功能、临床特征及预后等具有紧密联系,其中肥胖对COPD发病率具有较显著的影响,腹型肥胖是加剧COPD患者肺功能恶化的不利因素,而去脂体质量增加则有利于肺功能的改善.控制体质量有利于改善肥胖合并COPD患者的肺功能及运动耐力.     

不同严重程度中老年慢性阻塞性肺疾病患者135例肺功能损害与右心功能的关系

慢性阻塞性肺疾病(COPD)是一种以气流受限为特征的慢性呼吸系统疾病,其气流受限不完全可逆,呈进行性发展,最终可导致呼吸衰竭.COPD是目前引起人类死亡的主要疾病,根据最新的流行病学调查显示,我国40岁以上人群中COPD发病率为8.2％[1].COPD长期发展不但会对患者肺功能造成不可逆的损伤,也会引起肺心病、肺动脉高压、缺血性心脏病、动脉粥样硬化等疾病.这些变化与COPD引起的肺功能和右心功能损害密不可分.本文拟探讨不同严重程度的老年COPD患者肺功能损害对右心结构和肺动脉压力的影响.     

细胞焦亡在慢性阻塞性肺疾病中作用机制的研究进展

<正>慢性阻塞性肺疾病(Chronic obstructive pulmonary disease, COPD)是一种常见的慢性呼吸系统疾病，其特点是慢性呼吸道炎症和肺实质破坏，主要表现为不可逆的进行性气流受限，显著降低了患者的生活质量和运动耐力^[1]。目前关于COPD的发病机制尚不明确，探索COPD潜在的发病机制并进行预防对于减少COPD的发病率至关重要。目前认为，COPD发病的主要因素是炎症反应和细胞死亡^[2]。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.